Fahey, Michael C.

Fahey, Michael C. is an individual health care provider with primary practice located at 55 Lake Ave N Department Of Pediatrics, Worcester MA 01655-0002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Fahey, Michael C. can be contacted via phone (774) 441-7765.

Contact Information

Primary practice address
55 Lake Ave N Department Of Pediatrics Worcester MA 01655-0002
Phone: (774) 441-7765
Fax: (774) 441-8054
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 236443 New York
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 235218 Massachusetts

Profile Details

NPI number 1255536082
LBN Legal business name Fahey, Michael C.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2007
Last updated Jan 18th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255536082 NPPES
Massachusetts MEDICAID 110079829A

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